Provider Demographics
NPI:1619601747
Name:BARRETT, PAUL (RN MSN MBA)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:BARRETT
Suffix:
Gender:M
Credentials:RN MSN MBA
Other - Prefix:
Other - First Name:PAUL
Other - Middle Name:
Other - Last Name:BARRETT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN MSN MBA
Mailing Address - Street 1:802 N 31ST CT
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-6112
Mailing Address - Country:US
Mailing Address - Phone:786-575-7665
Mailing Address - Fax:
Practice Address - Street 1:802 N 31ST CT
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-6112
Practice Address - Country:US
Practice Address - Phone:786-575-7665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-14
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN1810582163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice